The resurgence of syphilis in high-income countries in the 2000s: a focus on Europe

Abstract

Syphilis can cause severe complications and sequelae. Following a decrease in reported cases in European Union/European Economic Area (EU/EEA) and other high-income countries in the 1980s and 1990s as a result of the HIV epidemic and ensuing changes in sexual behaviour, trends started to increase in the 2000s in a number of EU/EEA Member States with higher rates among men and a large proportion of cases reported among men who have sex with men (MSM), particularly HIV-positive MSM. Trends in EU/EEA Member States vary however with some countries continuing to report decreases in the number of reported cases (mostly in the Eastern part of EU/EEA) whereas many Western European countries report increasing numbers of cases. Increasing rates among women, although still relatively low, have been observed in a number of countries leading to concerns around mother-to-child transmission of syphilis and congenital syphilis. Similar overall trends are observed in other high-income countries with the exception of Japan where rates among heterosexual men and women have been rising at alarming levels. Control of syphilis requires use of comprehensive, evidence-based strategies which take into account lessons learned from previous control efforts as well as consideration of biomedical interventions.

Men treated for syphilis in Białystok, Poland,2014-2018

“…Zakażenie może być przeniesione z chorej ciężarnej kobiety do płodu, prowadząc do rozwoju kiły wrodzonej (1). Zapadalność na kiłę w Europie i innych krajach rozwiniętych wzrasta od 2010 r. (1,2). Średnie współczynniki zapadalności w Unii Europejskiej i Europejskim Obszarze Gospodarczym (UE/EOG) w latach 2014 -2017 systematycznie wzrastały od 5,39 do 7,07 przypadków na 100 000 mieszkańców.…”

“…Średnie współczynniki zapadalności w Unii Europejskiej i Europejskim Obszarze Gospodarczym (UE/EOG) w latach 2014 -2017 systematycznie wzrastały od 5,39 do 7,07 przypadków na 100 000 mieszkańców. Najwyższe współczynniki zachorowań w 2017 r. odnotowano w Niemczech, Islandii, Malcie, Hiszpanii i Wielkiej Brytanii (2,3).…”

“…Mężczyźni stanowią zdecydowaną większość wśród pacjentów z kiłą (ponad 85% przypadków w UE/EOG) (2,3). Odsetek mężczyzn chorych na kiłę w latach 2014-2017 stopniowo wzrastał z 86% do 89,5%, głównie w związku z wysoką zapadalnością wśród mężczyzn homoseksualnych (ang.…”

“…The disease can be also transmitted from infected pregnant woman to the foetus leading to congenital syphilis (1). Incidence rates of syphilis have been on the rise in Europe and other developed countries since 2010 (1,2). The average incidence in years 2014-2017 in the European Union (EU) and European Economic Area (EEA) increased gradually from 5.39 to 7.07 per 100,000 general population and the highest incidence was noticed in Germany, Iceland, Malta, Spain and the United Kingdom in 2017 (2,3).…”

Ancient bacterial genomes reveal a formerly unknown diversity ofTreponema pallidumstrains in early modern Europe

“…TEN is the causative agent of bejel, which is mostly found in hot and arid environments. Both of these treponematoses are usually milder in manifestations than syphilis, and have a lower incidence on the population level, yet their transmission rates have prevailed over the recent years 3,4 . Resistance against second-line antibiotics has recently developed in T. pallidum ssp.…”